Healthcare Provider Details

I. General information

NPI: 1255881421
Provider Name (Legal Business Name): ADEPT DEVELPOMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 ADELAIDE ST
ALBEMARLE NC
28001-5056
US

IV. Provider business mailing address

2216 CARTER DR
ALBEMARLE NC
28001-9647
US

V. Phone/Fax

Practice location:
  • Phone: 704-792-6009
  • Fax:
Mailing address:
  • Phone: 704-792-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier40335890
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: CHARLIE SWARINGEN
Title or Position: OWNER
Credential:
Phone: 704-792-6009